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Normal Cervical Effacement in Term Labor.

Janine S Rhoades1, Molly J Stout1, Candice Woolfolk1

  • 1Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri.

American Journal of Perinatology
|April 25, 2018
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Summary
This summary is machine-generated.

Cervical effacement varies during labor. However, by 8 cm dilation, 50% of patients are fully effaced, and by active labor (>6 cm), 95% have 1 cm or less residual cervix.

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine

Background:

  • Cervical effacement is a key indicator of labor progression.
  • Understanding the natural history of effacement is crucial for clinical management.

Purpose of the Study:

  • To estimate the natural history of cervical effacement during labor.
  • To analyze effacement patterns based on parity and labor type.

Main Methods:

  • Retrospective cohort study of 7,319 term, vertex, singleton deliveries (2010-2014).
  • Utilized interval-censored regression to model effacement progression over time.
  • Stratified analysis by parity (nulliparous vs. multiparous) and labor type (spontaneous vs. induced/augmented).

Main Results:

  • Multiparas showed faster effacement but less effacement at each dilation compared to nulliparas.
  • Spontaneous labor patients had faster and greater effacement than induced/augmented patients.
  • By 8 cm dilation, 50% of all patients were completely effaced; 95% had ≤1 cm residual cervix by >6 cm dilation.

Conclusions:

  • Significant variability exists in cervical effacement timing during labor.
  • In active labor, cervical effacement rapidly progresses, with most patients nearly or fully effaced.